Tackling the BAME social care workforce burnout crises

Featured article - 27 October 2021
Dr. Godfred Boahen, National Safeguarding Team, The Archbishops' Council

Godfred Boahen

A blog for Black History Month

In Black History Month, while we celebrate the achievements of BAME people, we should also reflect on workplace discrimination social care and commit to change this injustice. This has impeded diversity in senior management and deprived the workforce of critically needed talent. In health and social care, racism at work is sometimes characterised as ‘burn out’ – this is longstanding crisis, caused by a toxic mix of societal inequalities and workplace discrimination, and exacerbated by the effect of the pandemic on the workforce.

Racial inequalities in health and social care employment

It is recognised that BAME employees are subject to differential treatment in the labour market. The McGregor-Smith Review showed that BAME people are less likely to be employed than white people; they have fewer promotion opportunities when in work, are more likely to face disciplinary action and have their performances evaluated more harshly than their white colleagues. A recent Health and Social Care Committee found similar inequalities in the NHS, including disproportionate levels of harassment, bullying and outright racism. In social work, it is known that the BAME workforce is more likely to face formal disciplinary and regulatory processes such as Fitness to Practice investigations.

BAME professionals are also subject to informal sanctions such as unfair and biased performance evaluations and increased scrutiny of their conduct, which add to the already elevated levels of stress in social care. Informal discrimination can be pernicious because it involves gaslighting to make skilled professionals question their performance, thereby undermining their confidence. However being covert, victims cannot draw on formal safeguards in the workplace and therefore it can lead to a self-sustaining cycle of abuse, ‘underperformance’ and stress.

A less discussed cause of burnout in the BAME workforce is low pay and the ethnicity pay gap. BAME people are over-represented in entry level roles within the sector, which is characterised by persistent low-pay and workforce precarity. Described as ‘poverty-pay’ it causes ‘financial vulnerability of the majority of this workforce where a considerable proportion report finding it difficult or very difficult to manage their finance and are in receipt of some forms of welfare benefits indicating an overall low household income; within such context, poor wages are likely to have wider implications on workers’ well‐being and general quality of life.’ (Hussein, 2017; p.1824)

This means that tackling this entrenched inequality requires a combination of sector-specific and co-produced interventions and government investment in the workforce. This is urgent because unsurprisingly, the pandemic appears to have exacerbated workplace inequalities for BAME staff.

The long shadow of COVID-19

During the pandemic, the BAME Communities Advisory Group was formed as part of the Social Care Sector COVID-19 Support Taskforce, to provided policy advice to the government. The Advisory Group’s report was based on research with BAME social care staff and people who use services and their carers. The professionals explained that the disproportionate impact of COVID on their communities caused fear and anxiety within the workforce. They also believed that they experienced gatekeeping when they requested risk assessments and they were denied PPE. Therefore from the perspective of these BAME social care professionals, the pandemic evidenced existing discrimination and through this, it may have confirmed their suspicion that this was systemic. Among many unwelcome legacies, the pandemic may have further eroded BAME workforce’s trust in their employers but their enthusiastic participation in the consultations by the BAME Advisory Group strongly indicates that they want to be part of the solution to the crises.

The social care WRES: a historic opportunity for change

The causes of burnout in the BAME workforce are similar in health and social care however the decisive difference is that the NHS Workforce Race Equality Standard has been a catalyst for change in the NHS. It has evidenced the scale of disparities, thereby creating transparency and accountability. For this reason the first phase of the social care WRES is a landmark opportunity to address burnout and discrimination in social care. This should be an impetus for a whole-system approach to developing co-produced. Senior leadership in the sector should support this work and they should use the WRES as a platform for developing cross-sector solutions to the longstanding injustice faced by the BAME workforce.

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